Abstract P605: Neo-Traditional Diets Are Associated With Lower Odds of Metabolic Syndrome Among Adults in Puerto Rico
Authors: Abrania Marrero, Josiemer Mattei, Christopher D Golden, Sebastien Haneuse, Jose F Rodriguez-Orengo, Katherine L Tucker
Journal: Circulation (2023)

Prolonged marginalization of traditional food cultures has diminished local food production and increased dependence on highly processed imports in Puerto Rico (PR), contributing to low-quality diets and cardiometabolic disease. Recent efforts have been made to decolonize diets by increasing local food intake; however, what dietary patterns (DPs) exist and how they are associated with cardiometabolic disease risk remain unknown. This study aimed to 1 ) identify food-system-specific DPs and 2 ) determine associations with metabolic syndrome (MetS), a multicomponent cardiometabolic risk factor, among adults in PR. We hypothesized that a neo-traditional DP would emerge, characterized by use of minimally processed local foods and associated with lower odds of MetS. Data were obtained from adults (30-75 y) in the PR Observational Study of Psychosocial, Environmental, and Chronic Disease Trends ( n = 989). DPs were derived using partial least squares analysis on food frequency questionnaire data, with nutrients significantly associated with local food purchasing (fiber, magnesium [Mg], saturated fat) as response variables. MetS was classified using harmonized criteria from clinical and laboratory measures (waist circumference, fasting glucose, systolic/diastolic blood pressure, triglycerides, HDL cholesterol) and medication use. Fully adjusted generalized linear models tested associations between tertiles of DPs and MetS. Approximately half (52%) of participants were classified with MetS. Four DPs were extracted, described as neo-traditional (local plants and seafood), transitioning (beans and coffee), industrial: meat-centric (red/processed meats and fast foods), and industrial: sugar-centric (rice and sugary beverages). Individuals in the highest (vs. lowest) tertile of the neo-traditional DP were more likely to purchase local (not imported) fruits, vegetables, and seafood; those in the transitioning DP were more likely to reside in rural areas; those in the meat-centric DP were more likely to purchase local meats; and those in the sugar-centric DP had lower educational attainment and household income. Individuals in the highest (vs. lowest) tertile of the neo-traditional DP were 0.69 (0.49, 0.97) times less likely to have MetS ( P = 0.035); they also had 4.1 (1.3) cm lower mean (SE) waist circumference ( P = 0.002). In contrast, individuals in the highest (vs. lowest) tertile of the meat-centric DP had higher mean waist circumference (102 vs. 99 cm, P = 0.01), fasting glucose (106 vs. 98 mg/dL, P = 0.019), and systolic blood pressure (123 vs. 119 mmHg, P = 0.022). The sugar-centric and transitioning DPs were not significantly associated with MetS or its components. A neo-traditional diet in PR holds promise in supporting local food production and augmenting cardiometabolic health. Results can guide local food promotion as a healthful, decolonizing approach in island settings.